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Comfort care

  • Admission orders

    • Admit: Floor
    • Diagnosis: Comfort Care
    • Condition: Serious
    • Vital Signs: Prn only if needed to guide therapy
    • Allergies:
    • Nursing:
      • Oxygen 0-6 L/min nasal cannula prn dyspnea. Titrate to patient comfort
      • Suction only for severe throat secretions
      • Oral care q 2 hours and prn
      • Condom catheter or foley prn for patient comfort
    • Diet: As Tolerated
    • Activity: As Tolerated
    • Labs: None
    • IV: None
    • Special: complete DNR, social work, pastor/spiritual care consult
    • Medications:
      • Pain med
        • Morphine sulfate immediate release 10-30 mg PO/sublingual (SL) q 2 hours prn pain
        • or morphine sulfate 1-2 mg IV q 1 hour prn pain
        • or morphine sulfate continuous IV infusion at 1-2 mg/h
        • For inadequate pain relief with continuous infusion, bolus with dose equal to current hourly rate and increase infusion by 25-50% q 30 minutes prn pain
      • Constipation
        • Docusate 250 mg PO bid for any patient on narcotics. Hold for loose stool
        • Senna 2 tablets PO bid for any patient on narcotics. Hold for loose stool
        • Milk of magnesium 30 mL PO bid prn constipation
        • Bisacodyl suppository 1 PR qd prn constipation
      • Itching
        • Diphenhydramine 25-50 mg PO/IV q 6 hours prn itching or insomnia
      • Diarrhea
        • Diphenoxylate/atropine (Lomotil) 1-2 tablets PO q 4 hours prn diarrhea. Limit 8 tablets/24 hours
      • Fever
        • Tylenol 650 mg PO/PR q 4-6 hours prn pain or fever
      • Nausea
        • Metoclopramide 10 mg PO/IV q 4 hours prn nausea
        • Promethazine 12.5-25 mg PO/IV q 4 hours prn nausea
        • Prochlorperazine 25 mg suppository PR q 8 hours prn nausea
      • Insomnia
        • Zolpidem 5-10 mg PO qhs prn insomnia
      • Cough
        • Dextromethorphan 15-30 mg PO qid prn cough
        • Benzonatate 100 mg PO qid prn cough
      • Anxiety
        • Lorazepam 0.5-1 mg PO/SL/IV q 1 hour prn anxiety/restlessness/dyspnea
      • Secretions
        • Scopolamine patch 1.5 mg topically to mastoid q 72 hours prn secretions
        • Atropine 0.4 mg SQ q 3 hours prn secretions
  • Discharge

    • Hospice or nursing home

  • Print | Citations

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